Hemodynamic and pulmonary changes during and after laparoscopic cholecystectomy. A comparison with traditional surgery.
BACKGROUND
The cardiopulmonary changes experienced by patients who undergo laparoscopic cholecystectomy (LC) and the prognostic value of patient characteristics are not well understood.


METHODS
Cardiorespiratory changes were investigated in 120 patients undergoing LC or open cholecystectomy (OC). The results and their relation to patient variables were statistically evaluated.


RESULTS
The most significant cardiorespiratory changes were (A-a)PO2 increase during OC; decrease of pH and compliance and increase of peak airway pressure during LC; impairment of arterial blood gas mean values and respiratory muscle strength; atelectasis and pneumonia (five cases) after OC; and lamellar atelectasis (two cases) after LC. Significant adverse prognostic factors related to intra- and postoperative LC cardiorespiratory changes were ASA class greater than I, FEF75-85% < 900 ml, and PaO2 < 10.4 kPa (PPV, 71.4% and 46.6%, respectively).


CONCLUSIONS
LC carries no significant cardiorespiratory changes provided that intraoperative monitoring of hemodynamics and respiratory parameters is done for the study of blood gas values in all patients at risk.
Volpino
P
P
First Department of Surgery, University of Rome La Sapienza, Italy.
Cangemi
V
V
D'Andrea
N
N
Cangemi
B
B
Piat
G
G
D002245:Carbon Dioxide / Q000008:administration & dosage; D017081:Cholecystectomy, Laparoscopic; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D007431:Intraoperative Complications / Q000503:physiopathology; D007813:Laparotomy; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D011183:Postoperative Complications / Q000503:physiopathology; D011379:Prognosis; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D012307:Risk Factors
D002245:Carbon Dioxide